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MENNONITE HOME OF ALBANY INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MENNONITE HOME OF ALBANY INC (EIN 93-0473211)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-05-30
IRS object ID
201221519349300312
Schema version
2010v3.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-30T09:48:28-07:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Hansen Hunter & Co PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line18930 SW Gemini DriveAddressLine1
CityBeavertonCity
StateORState
ZIP Code97008ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930473211EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mennonite Home of Albany IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMENNNameControl
Phone5419287232Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15353 Columbus Street SEAddressLine1
CityAlbanyCity
StateORState
ZIP Code97322ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCHESTER PATTERSONName
TitleCFOTitle
Date Signed2012-05-29DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameCynthia J HeubergerName
Phone5032442134Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRonald LitwillerNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15353 COLUMBUS STREET SEAddressLine1
CityALBANYCity
StateORState
ZIP Code97322ZIPCode
FieldValueIRS element (for citing)
Gross Receipts23232395GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWWW.MENNONITEVILLAGE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTH CARE AND HOUSING FOR THE ELDERLY AND THOSE WITH ALZHIEMER'S AND DEMENTIA.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees503TotalNbrEmployees
Total Nbr Volunteers100TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year548884ContributionsGrantsPriorYear
Contributions Grants Current Year63614ContributionsGrantsCurrentYear
Program Service Revenue Prior Year21659912ProgramServiceRevenuePriorYear
Program Service Revenue CY22760175ProgramServiceRevenueCY
Investment Income Prior Year245054InvestmentIncomePriorYear
Investment Income Current Year354974InvestmentIncomeCurrentYear
Other Revenue Prior Year8979OtherRevenuePriorYear
Other Revenue Current Year-462OtherRevenueCurrentYear
Total Revenue Prior Year22462829TotalRevenuePriorYear
Total Revenue Current Year23178301TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year12930GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY18865GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year12021336SalariesEtcPriorYear
Salaries Etc Current Year12399716SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year134745TotalFundrsngExpCurrentYear
Other Expense Prior Year9144510OtherExpensePriorYear
Other Expenses Current Year9534087OtherExpensesCurrentYear
Total Expenses Prior Year21178776TotalExpensesPriorYear
Total Expenses Current Year21952668TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1284053RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1225633RevenuesLessExpensesCY
Total Assets BOY47255344TotalAssetsBOY
Total Assets EOY48203774TotalAssetsEOY
Total Liabilities BOY30951892TotalLiabilitiesBOY
Total Liabilities EOY30665374TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY16303452NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY17538400NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HEALTH CARE AND HOUSING FOR THE ELDERLY AND THOSE WITH ALZHIEMER'S AND DEMENTIA.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense19391015Expense
Grants18865Grants
Revenue22760175Revenue
DescriptionMENNONITE HOME OF ALBANY PROVIDES ELDERLY ASSISTED LIVING CARE, IN-HOME CARE, RETIREMENT LIVING AND HIGH QUALITY HEALTH CARE TO ALZHEIMERS AND DEMENTIA PATIENTS.Description
Total Program Service Expense19391015TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109610NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees503NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonChester Patterson CFONamePerson
Telephone Number5419287232TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15353 COLUMBUS STREET SEAddressLine1
CityALBANYCity
StateORState
ZIP Code97322ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
TIM ROTH
Director2.00X000
LOWELL KROPF
Director2.00X000
NANCY FRIESEN
Director2.00X000
Ronald Litwiller
President & CEO60.00018796613457X
CHESTER PATTERSON
CFO55.00012934311698X
ROBERT JOHNSON
COO55.00011019411124X
DONNA MILLER
Secretary2.00X000X
DAVE MILLER
Director2.00X000
ELLIS STUTZMAN
Director2.00X000
GINA UMBLE
Director2.00X000
WELDON BURKHOLDER
Board ViceChair2.00X000X
WILL BARNHART
Board Chair3.00X000X
RANDY FRIESEN
Director2.00X000
ROB HAYS
ADMINISTRATOR50.00010864311077X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs536146TotalReportableCompFrmRltdOrgs
Total Other Compensation47356TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MENNONITE MANAGEMENT SERVICES
5353 COLUMBUS ST SEALBANYOR97322MANAGEMENT SERVICES944455
CONSONUS REHAB
4560 SE INTERNATIONAL WAYportlandOR97222THERAPY SERVICES1010570
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Related Organizations55949RelatedOrganizations
All Other Contributions7665AllOtherContributions
Total Contributions63614TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESIDENT RESTAURANT623000465029465029
ENTRANCE FEE AMORT.62300015188311518831
Fees & Contracts Gov Agencies62300067919286791928
RESIDENT SERVICES6230001398438713984387
FieldValueIRS element (for citing)
Total Program Service Revenue22760175TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column268876TotalRevenueColumn
Exclusion$268,876ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real38338Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real38800Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-462Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-462TotalRevenueColumn
Exclusion-$462ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities101392Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other15294Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities101392Securities
Other-15294Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column86098TotalRevenueColumn
Exclusion$86,098ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column23178301TotalRevenueColumn
Related Or Exempt Function Income22760175RelatedOrExemptFunctionIncome
Exclusion$354,512ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1400Total
Program Services1400ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total17465Total
Program Services17465ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total9275865Total
Program Services8542172ProgramServices
Management And General663867ManagementAndGeneral
Fundraising69826Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total155890Total
Program Services135035ProgramServices
Management And General14257ManagementAndGeneral
Fundraising6598Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1959966Total
Program Services1781376ProgramServices
Management And General169548ManagementAndGeneral
Fundraising9042Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1007995Total
Program Services904990ProgramServices
Management And General96615ManagementAndGeneral
Fundraising6390Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1053771Total
Program Services357889ProgramServices
Management And General695882ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2421Total
Management And General2421ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total27538Total
Management And General27538ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total29644Total
Management And General29644ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1567911Total
Program Services1375119ProgramServices
Management And General192552ManagementAndGeneral
Fundraising240Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total174944Total
Program Services21737ProgramServices
Management And General152035ManagementAndGeneral
Fundraising1172Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total826121Total
Program Services811153ProgramServices
Management And General14968ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total70590Total
Program Services60828ProgramServices
Management And General9154ManagementAndGeneral
Fundraising608Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total48799Total
Program Services30039ProgramServices
Management And General17541ManagementAndGeneral
Fundraising1219Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total713571Total
Program Services700642ProgramServices
Management And General12929ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1524682Total
Program Services1494188ProgramServices
Management And General30494ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total292263Total
Program Services267373ProgramServices
Management And General24890ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralFundraisingFundraisingProgram ServicesProgramServices
MISCELLANEOUS47929379429987
PROPERTY TAXES2553414626250715
EQUIPMENT RENTAL & maintenance2899038162281741
FOOD COSTS10546761054676
SUPPLIES1331705909281240777

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total222278Total
Program Services61700ProgramServices
Management And General130915ManagementAndGeneral
Fundraising29663Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total21952668Total
Program Services19391015ProgramServices
Management And General2426908ManagementAndGeneral
Fundraising134745Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY17603BOY
EOY15622EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5630156BOY
EOY6329860EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1441416BOY
EOY1289426EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY35803BOY
EOY43463EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY167179BOY
EOY210013EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis49450304LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec18884439LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY29996037BOY
EOY30565865EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY8101684BOY
EOY8473589EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1865466BOY
EOY1275936EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY47255344BOY
EOY48203774EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1733327BOY
EOY2001659EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY10094863BOY
EOY10239754EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY11995353BOY
EOY11176242EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY6505BOY
EOY8364EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1272931BOY
EOY1222727EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5848913BOY
EOY6016628EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY30951892BOY
EOY30665374EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY16303452BOY
EOY17538400EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16303452BOY
EOY17538400EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY47255344BOY
EOY48203774EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1225633ReconcilationRevenueExpenses
Reconcilation Other Changes9315ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years90577CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years68336CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years50854CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year548884CurrentTaxYearMinus1Year
Current Tax Year63614CurrentTaxYear
Total822265Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19423947CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years20019198CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years20954193CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21659912CurrentTaxYearMinus1Year
Current Tax Year22760175CurrentTaxYear
Total104817425Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19514524CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years20087534CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21005047CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22208796CurrentTaxYearMinus1Year
Current Tax Year22823789CurrentTaxYear
Total105639690Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509105639690PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years303182CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years366250CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years335153CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year253407CurrentTaxYearMinus1Year
Current Tax Year307214CurrentTaxYear
Total1565206Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years303182CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years366250CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years335153CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year253407CurrentTaxYearMinus1Year
Current Tax Year307214CurrentTaxYear
Total1565206Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19817706CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years20453784CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21340200CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22462203CurrentTaxYearMinus1Year
Current Tax Year23131003CurrentTaxYear
Total107204896Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98540PublicSupportPercentage509
Prior Year Support Percentage0.98480PriorYearSupportPercentage
Investment Income Percentage0.01460InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01520PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5384465OtherCostOrOtherBasis
Book Value5384465BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis37534014OtherCostOrOtherBasis
Depreciation14475445Depreciation
Book Value23058569BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3148971OtherCostOrOtherBasis
Depreciation2062872Depreciation
Book Value1086099BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3382854OtherCostOrOtherBasis
Depreciation2346122Depreciation
Book Value1036732BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings30565865TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
REFUNDABLE ENTRANCE FEES$5,885,128
VILLAGE UNIT DEPOSITS$131,500
FieldValueIRS element (for citing)
Total Of Amounts6016628TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart IV, Line 2bIdentifier
Return ReferencePart IV, Line 2b: Explanation of escrow account liabilityReturnReference
ExplanationThe organization maintains funds for the convenience of its residents. These amounts are listed as both an asset and a liabiltiy on the organization's balance sheet.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000
Total Nbr Of501 C3 And Govt Grants0TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantScholarshipsTypeOfGrant
Number Of Recipients13NumberOfRecipients
Amount Of Cash Grant17465AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrantmaker's Description of How Grants are UsedIdentifier
ExplanationScholarship grants are monitored by a Scholarship Committee consisting of staff and residents as well as a representative from Human Resources.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonRonald LitwillerNamePerson
Comp Based On Related Orgs187966CompBasedOnRelatedOrgs
Deferred Comp Related Orgs5639DeferredCompRelatedOrgs
Nontaxable Benefits Related Orgs7818NontaxableBenefitsRelatedOrgs
Total Compensation Related Orgs201423TotalCompensationRelatedOrgs

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Hospital Facility AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN936002114IssuerEIN
CUSIP Number012508AR8CUSIPNumber
Date Issued2004-09-30DateIssued
Issue Price8470000IssuePrice
Description Of PurposeRefunding/Congregate Care FacilityDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired3955000AmountRetired
Total Proceeds8823310TotalProceeds
Amount In Reserve Fund231296AmountInReserveFund
Refunding Escrow6043907RefundingEscrow
Issuance Costs From Proceeds313383IssuanceCostsFromProceeds
Capital Expenditures2234725CapitalExpenditures
Year Of Subst Completion2005YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingtrueAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedtrueBondCounselRoutinelyEngaged
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledtrueForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonKaren LitwillerNamePerson
FieldValueIRS element (for citing)
RelationshipEmployeeRelationship
Amount Of Transaction95780AmountOfTransaction
Description Of TransactionWagesDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThese documents are made available to the public by request at the organization's place of business.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsConflicts of interest are disclosed at each meeting of the board of directors and/or meetings of the standing board committees. Known conflicts are addressed at each meeting by the board chair. An annual conflict of interest statement is signed by all members.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessThe form and supporting schedules are reviewed by the finance committee of the board of directors prior to being filed. Each board member receives a complete copy of Form 990 and schedules.
Form 990, Part VI, Line 7aForm 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyMennonite Health Services, the organization's sponsor, appoints all board members.
Form 990, Part VI, Line 2Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtRandy Friesen and Nancy Friesen have a family relationship.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Mennonite Management Services
5353 Columbus St SEAlbanyOR97322743192567Management ServicesOR501(c)39N/Afalse
Mennonite Health Services
234 South Main StGoshenIN46526231421919Health ServicesIN501(c)39N/Afalse
Albany Mennonite HOmeVillage Foundation
5353 Columbus St SEAlbanyOR97322931049860Support Mennonite Home of AlbanyOR501(c)311, Type IItrueMennonite Home of Albany
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Albany Mennonite HOmeVillage FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypecTransactionType
Amount Involved55949AmountInvolved
Method Of Amt Determinationcash valueMethodOfAmtDetermination